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Abstract Number: 135

Comparison of the Ultrasonography Images and Synovial Pathology of the Joints in Patients with Rheumatoid Arthritis Treated with Biological Agents

Asami Abe1, Hajime Ishikawa1 and Akira Murasawa2, 1Rheumatology, Niigata Rheumatic Center, Shibata, Japan, 2Niigata Rheumatic Center, Shibata, Japan

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Biologic agents, pathogenesis and ultrasonography, rheumatoid arthritis

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Session Information

Title: Imaging of Rheumatic Diseases: Ultrasound

Session Type: Abstract Submissions (ACR)

Background/Purpose: An early diagnosis and tight disease control have increased in importance in the era of biological therapy for rheumatoid arthritis (RA).  Ultrasonography (US) of the various joints permits an evaluation of synovitis and bone erosion in real time.  It has proven to be useful to detect synovitis in the early stage of the disease.The objectives of this study were to investigate whether the ultrasonography (US) images of a surgically-treated joint reflect synovial pathology or clinical indicators, and to compare the results in patients using non-biological agents (NB) and biological agents (Bio) for disease control.

Methods: Rheumatoid arthritis (RA)-related orthopedic surgery was performed in 301 joints, including five shoulders, 43 knees, 36 elbows, 90 wrists, 75 fingers, nine ankles and 43 toes between January 2011 and September 2013. US was performed preoperatively, and the grade of the Power Doppler (PD) signal was weighted.  The Rooney score of the synovial pathology, the DAS28-ESR (4), and the MMP-3 and CRP levels were investigated. The Bio treatments were IFX in 13, ETN in 22, TCZ in 18, ADA in seven, ABT in one, GLM in four and CZP in three. 

Results: The PDS, DAS28, MMP-3 and Rooney score in the patients using Bio were significantly lower than those in the patients using NB. The MMP-3 values for the patients using ETN were higher than those for the patients using IFX, and the DAS28 was higher for patients using ETN than for patients using TCZ. The DAS28 and fibrosis (as a Rooney score item) in the patients using TCZ were significantly lower than those in patients using TNF-α inhibitors. The PDS, CRP, MMP-3 and Rooney score in the patients using IFX were significantly lower than those in the patients using NB. The PDS, DAS28 and Rooney score in the patients using TCZ were significantly lower than those in the patients using NB. However, there were no significant differences in any items between patients using NB and patients using ETN or ADA.

Conclusion: The activity of RA synovitis at the surgically-treated site was suppressed in patients using Bio. There were some differences in the clinical data, pathological scores, PDS and DAS28 among the patients receiving different types of Bio.


Disclosure:

A. Abe,
None;

H. Ishikawa,
None;

A. Murasawa,
None.

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